Individual
SAOUSSAN ALFAHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2490 CENTRAL AVE, LAKE STATION, IN 46405-2122
(219) 763-8112
(219) 962-1808
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 962-1808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01078593A
IN
208000000X
Pediatrics Physician
036.125340
IL
390200000X
Student in an Organized Health Care Education/Training Program
125.052662
IL
Other
Enumeration date
11/17/2008
Last updated
07/21/2022
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